Evidence map›Paper›PMID 36208405›Full record

ArticleJournal of nephrology2023

Induction therapy for pediatric onset class IV lupus nephritis: Mycophenolate Mofetil versus Cyclophosphamide.

Marwa Chbihi, Laurye-Anne Eveillard, Quentin Riller, Romain Brousse, Romain Berthaud, Pierre Quartier, Rémi Salomon, Marina Charbit, Marina Avramescu, Nathalie Biebuyck and 5 more

Open access · greenAbstract read
PubMed Publisher
In one paragraph

Article in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Do we really need cyclophosphamide for lupus nephritis?Pediatric nephrology (Berlin, Germany) · 2024
    Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Marwa Chbihi *Pediatric Immunology-Hematology and Rheumatology Unit, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Inserm U1163, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Imagine Institute, Paris, France. marwa.chbihi2@aphp.fr.ORCID http://orcid.org/0000-0002-2771-851X
Laurye-Anne Eveillard *Pediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Quentin RillerLaboratory of Immunogenetics of Pediatric Autoimmune Diseases, Inserm U1163, Paris Cité University, Imagine Institute, Paris, France.
Romain BrousseDepartment of Pathology, Necker-Enfants Malades Hospital, APHP, Paris Cité University, Paris, France.
Romain BerthaudPediatric Nephrology, MARHEA Reference Center, Paris Cité University, Necker-Enfants Malades Hospital, AP-HP, Paris, France.
Pierre QuartierPediatric Immunology-Hematology and Rheumatology Unit, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Inserm U1163, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Imagine Institute, Paris, France.
Rémi SalomonPediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Marina CharbitPediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Marina AvramescuPediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Nathalie BiebuyckPediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Laurène DehouxPediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Nicolas GarcelonInserm U1163, Imagine Institute, Paris Center University, Paris, France.
Jean-Paul Duong-Van-HuyenDepartment of Pathology, Necker-Enfants Malades Hospital, APHP, Paris Cité University, Paris, France.
Brigitte Bader-Meunier *Pediatric Immunology-Hematology and Rheumatology Unit, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Inserm U1163, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Imagine Institute, Paris, France.
Olivia Boyer *Pediatric Nephrology, Inserm U1163, MARHEA Reference Center, Imagine Institute, Paris Cité University, Necker-Enfants Malades Hospital, APHP, Paris, France.
Inserm · FRHôpital Necker-Enfants Malades · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesClass IV lupus nephritis (LN) is one of the most frequent and severe types of involvement in pediatric systemic lupus erythematosus. Gold standard treatment consists of intravenous (i.v.) Cyclophosphamide (CYC) associated with corticosteroids. Recent studies in adults have shown similar efficacy of oral Mycophenolate Mofetil (MMF) with fewer adverse events. Our aim was to compare the efficacy and tolerance of CYC and MMF as induction therapy in children with class IV LN.

methodsWe conducted a retrospective study of children diagnosed with class IV LN who started oral MMF or i.v. CYC treatment at Necker Enfants Malades Hospital (Paris, France).

resultsThe study included 33 patients, 17 treated with oral MMF (51%) and 16 with i.v. CYC (48%). The characteristics at treatment induction did not significantly differ between the two groups except for the neurological involvement, that was only present in the CYC group. Complete remission was obtained in 9/17 (53%) children treated with MMF versus 10/16 (71%) treated with CYC (p = 0.46). Relapse was observed in 59% of patients receiving MMF versus 50% receiving CYC (p = 0.87), after a median of 3.4 years and 4.7 years after the beginning of treatment, respectively (p = 0.41). During the 6.5 years of follow-up, we observed no significant difference regarding the number of treatment-related adverse events between the two groups (p = 0.48).

conclusionWe report similar efficacy and tolerance of MMF or CYC as induction therapy of class IV LN in children. However, the long-term adverse events such as infertility could not be systematically evaluated in this retrospective pediatric study. Overall, however, considering the long-term safety profile reported in the literature, we suggest that MMF may be used as first-line induction therapy in LN.

Indexed as

Lupus NephritisAdultChildCyclophosphamideHumansImmunosuppressive AgentsInduction ChemotherapyMycophenolic AcidRetrospective StudiesCyclophosphamideImmunosuppressive AgentsMycophenolic AcidCyclophosphamideLupus erythematosusMycophenolate MofetilNephritisPediatricSystemicTreatment outcome

Identifiers

PMID36208405
OpenAlexW4303644842

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.